Calls have been made for urgent action to be taken to solve an overcrowding crisis at the emergency department at the Mid Western Regional Hospital in Limerick.
The emergency department has 38 people waiting on trolleys for the second day in a row, which is the highest figure in the country.
Hospital authorities have again asked people not to attend the emergency department unless the emergency is genuine.
The hospital authorities cannot attribute the crisis to any particular illness in the community, high numbers of acutely unwell patients over 70 are presenting and they all require hospital admission.
It is the third time since last Friday that the hospital has asked people not to attend unless they have a genuine emergency.
Local INMO representative Mary Fogarty said the situation is completely unsafe for nurses and patients.
She said that cutbacks in community nursing services and home help services are now having an effect on the high numbers, particularly of elderly people, turning up at the emergency department in Limerick.
The hospital's chief executive, Ann Doherty, said the majority of people awaiting admission in the emergency department were medical patients.
Speaking on RTÉ's News at One, she said the hospital seemed to be experiencing a pressure point it had not seen before.
She said that while the rate of attendances at emergency departments is about the same year-on-year, the demand for patients who need to be admitted has increased over time.
Ms Doherty said the challenge of capacity across the midwest is being addressed.
She said there are plans to open new beds on the Dooradoyle site when the new critical care block is fully occupied.
Ms Doherty said six beds are already open on the Dooradoyle site and a full capacity of 21 beds will be available by the end of the year.
She also said there are ongoing talks about putting arrangements in place to open 20 beds in St John's Hospital over the coming days.
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